Today, the health care industry focuses on designing programs and products to manage patient problems in a useful, efficient, cost-effective and consumer-oriented manner. Hospital staff members, numerous health care providers and representatives of pharmaceutical research and development industry play an important decision-making role in determining the treatment for disease. However, that role is still ancillary to the patient's primary care physician who diagnoses the patient's problem and provides an individualized treatment regimen. Current treatment for many kinds of patients' problems reflects the health care industry's change of perspective from an episodic, systematic treatment of disease to the reduction of risk factors the prevention of disease, and the reduction of health care costs. A rapid dissemination of large amounts of information regarding the effectiveness of treatment regimens, the cost-effectiveness of these regimens, and of patient reactions to their health care complements this change of focus.
As a result of the focal change, many participants within the healthcare industry require rapid access to a large database of patient information about diagnosis, treatment, health outcomes, costs, and patient perspectives on their diagnosis, treatment within the context of the practice to which they belong. This information can be used to respond to research/practice generated questions regarding some or all of the following: (i) the most effective treatment for a disease or patient problem, (ii) regimens or methods of reducing risk and increasing adherence (iii), the costs to the practice associated with therapeutic regimens, (iv) degree of patient satisfaction, and patient satisfaction with and adherence to regimens, (v) differences of (i-iv) within different practice types, specialties, or geographic regions. The information falls into three areas: clinical information, physician/patient information, practice management/cost information, and health outcomes information.
Available survey methods and databases that collect and analyze these surveys have not been designed in a user-friendly, easily accessible manner that physicians can use to monitor patients and their practices. The primary sources for patient information have been hospital records/data; pharmaceutical industry studies, prescription information, and medical or healthcare provider claims databases. These databases often lack information about one or more of the following: diagnosis, treatment, the patient's perceptions of the diagnosis and treatment, and costs to the practice of the patient's care and perceptions of care. The research activities requiring this information may take many forms: determining which treatment for a disease is most effective, determining the costs associated with particular kinds of treatment, or identifying at-risk patient and patients' reactions to the diagnosis, treatment, and services provided.
Further, systems which attempt to provide automated health care management do not necessarily have direct input from the patient about the care given during a patient's visit. Such systems usually rely on claims and physician's files, as well as insurance information; such a system is disclosed in U.S. Pat. No. 5,301,105 entitled ALL CARE HEALTH MANAGEMENT SYSTEM, to Desmond D. Cummings, Jr. Other systems are designed to review and control data quality of patient data collected as clinical data for reporting of hospital claims, such as disclosed in U.S. Pat. No. 5,307,262 entitled PATIENT DATA QUALITY REVIEW METHOD AND SYSTEM, to Paul Y. Ertel. These systems, however, are not designed to collect patient data associated with a physician's interaction and treatment of the patient, and with the patient's visit to a practice. Finally, some devices are designed to collect patient satisfaction data associated with a physician's drug treatment plan, while also collecting clinical trial information. Such a system is described in U.S. Pat. No. 5,642,731 entitled METHOD AND APPARATUS FOR MONITORING THE MANAGEMENT OF DISEASE, to Bruce A. Kehr. These systems are, however, tailored to specific drug treatment plans.
Past efforts to assemble such a database and system have failed because of a difficulty of acquiring such information without interfering with the physician's practice. Industry attempts to install computers within a practice, or assemble the information through surveys suffer from the following problems. First, physicians have been trained to prepare an immediate and long range patient plan based upon their own knowledge rather than to gather survey information from patients. Second, physicians know the importance of keeping patient information confidentially and, therefore, will not readily divulge information from their patient records. Third, physicians have no easy way to relate one portion of the care they provide (e.g., how the patient is greeted) to another aspect of care (e.g., patient adherence to a regimen.) Fourth, if the physician directly asks a patient about the office services and clinical care, the patient may not give accurate and unbiased responses. Therefore, there is a need for a method of acquiring Physician/Patient/Practice information which a) is simple to implement (requires only a few minutes of the physician's and the patients' time); and b) maintains the confidentiality of each patient.